The metabolic response to trauma has routinely been investigated in the postabsorptive, or fasting, state. Information is needed regarding the effect of modern nutritional support on posttraumatic catabolism in order to gain the maximum benefit from these new feeding techniques. The studies in this application utilize regional catheterization techniques in order to assess the effect of nutritional support on the metabolism of injured patients. The goals are to provide a systematic description of the patterns of interorgan movements and regional metabolism of major substrates and hormones in both man and dogs subjected to trauma, sepsis or depletion. Catheters will be placed in the hepatic vein, femoral vein and an artery in surgical patients, as well as normal volunteers. In dogs, intestine, kidney, brain and spleen will also be studied. Blood flow will be measured in the liver by clearance and in other regions by dilution of indocyanine green. Flow, multiplied by concentration differences across each region will give net output, or uptake, for individual amino acids, ammonia, urea, glucose, glycerol, lactate, pyruvate, fatty acids and ketone bodies. Net rates of protein synthesis, or breakdown, in each region will be derived from the sum of all nitrogen containing substrates. Plasma insulin, glucagon, growth hormone and cortisol and urinary catecholamines will be measured. The respiratory quotient which rises above 1.0 with lipogenesis during hyperalimentation is being measured across the splanchnic bed to determine whether acute injury, or infection, inhibits this process.